Provider Demographics
NPI:1508915489
Name:KRUEGER EYECARE, INC.
Entity Type:Organization
Organization Name:KRUEGER EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:KRUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:563-262-8161
Mailing Address - Street 1:3003 N HIGHWAY 61
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-5811
Mailing Address - Country:US
Mailing Address - Phone:563-262-8161
Mailing Address - Fax:563-262-8987
Practice Address - Street 1:3003 N HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-5811
Practice Address - Country:US
Practice Address - Phone:563-262-8161
Practice Address - Fax:563-262-8987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02118152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty